Meeting 5 Move More,

Sit Less! We are so pleased to see you again! Today we are going to talk about physical activity and glucose balance. Before we get started with today’s meeting, let’s take a few minutes to review the key points from the first four meetings. In meeting 1, Glucose Balance Makes a Difference, we said to get and keep your glucose in balance, it is important to: Know your glucose numbers, Know what makes them go up and down, Self-test often, with a goal of 70 - 130 before eating,

and lower than 180 two hours after eating, and Get A1c lower than 7.

In meeting 2, Medicine and Glucose Balance, we said: Diabetes medicine is an important part of a diabetes

treatment plan, and Diabetes medicine works together with healthy

eating and physical activity to lower blood sugar.

Welcome!

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In meeting 3, Food and Glucose Balance, we said to: Develop a routine to eat your meals and snacks

at about the same time each day.

Eat a variety of foods high in fiber and low in fat, calories and sugar, such as whole wheat bread, brown rice, and vegetables.

Avoid foods high in fat or oil, like fried foods, bacon, sausage, mayonnaise, and cheeses.

Read food labels to find the best foods for glucose balance!

In meeting 4, Plan Meals for Glucose Balance, we said: The three main food plans for glucose balance

are: 1) The Exchange Meal Plan 2) The Glycemic Index Plan 3) The Counting Carbohydrates Plan

Counting Carbohydrates Plan may be the easiest

to do because you can read food labels to monitor the number of carbs you eat.

Now let’s hear what Uncle Tommy and Kaipo are doing to Move More and Sit Less!

Move More, Sit Less! Meeting 5

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It is Saturday morning and Uncle Tommy and Auntie Nani have just finished breakfast. Auntie Nani has invited Kaipo over to go for a walk with them on the beach. She sometimes has a hard time getting Uncle Tommy out of the house, unless it’s for fishing. Auntie Nani knows that Uncle needs to get more exercise to keep his weight under control and his blood sugar lower. Let’s hear how their walk goes. “Hi Auntie and Uncle!” Kaipo said as he entered the front door. Kaipo was wearing his surfing shorts, a t-shirt, and was holding his soccer ball. Auntie came over and gave him a big hug and asked, “Are you ready to go to the beach?” “Yep, and I brought the soccer ball so Uncle and I can practice some passes,” said Kaipo. Uncle walked out into the living room in his shorts, t-shirt and a big straw hat. Kaipo laughed a little at how big the hat was, but it didn’t bother Uncle. “Auntie, you ready to go?” asked Uncle. “Yes, let’s get going so we can get a parking place,” replied Auntie Nani. The three got into the truck and and headed for the beach. It was another beautiful day! There was still plenty of parking and open beach to set up on. Kaipo ran to the water and jumped in. Uncle Tommy and Auntie Nani set up the canopy and chairs.

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Kaipo came running back from the ocean and got his soccer ball out of the truck. “Uncle, come kick the ball with me,” Kaipo yelled. “Why don’t you both kick the ball down the beach while we take a walk?” Auntie Nani suggested. “Great idea, Auntie,” said Kaipo. Uncle put his sneakers on and met Kaipo out on the sand. They passed the ball back and forth while they all walked. It was still early so it wasn’t too hot yet, but Auntie brought some water along for the walk. They walked for about 20 minutes and then turned around and headed back. Uncle was sweating a little and breathing hard after playing with Kaipo. When they got back to their spot on the beach, Uncle strolled into the water to cool off. When he came back to the canopy, Auntie had a snack waiting for him. “How do you feel?” asked Auntie Nani. “I feel great! The walk and kicking the ball with Kaipo was fun. Maybe we can come down here every other day and go for a walk,” replied Uncle. “Kaipo, can you remind me and Uncle about our walk every other day?” asked Auntie. Kaipo said, “Sure! And I can practice kicking and passing the soccer ball while we walk. It will be good for all of us!”

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Meeting 5

Did you know that a person can prevent or delay diabetes by being physically active? And people with diabetes can prevent complications, such as heart problems, with regular physical activity. Daily physical activity is the foundation of healthy living for everyone! We know you’ve probably been told be more physically active, but some people don’t know exactly what that means. Let’s take a few minutes and talk about what physical activity is. Physical activity is regular movement of your body. To be physically active, you should stay active for at least 10 minutes at a time. It is best if you can do this at least 3 times per week. A goal to work toward is to increase the time you are physically active from 20 to 60 minutes on most days of the week.

What is Physical Activity?

Physical activity is great for everyone!

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Being physically active means that: You do it at least 10 minutes a day all at one time

(work up to at least 30 minutes)

You do it at least 3-4 times per week

Your heart beats faster

You sweat a little

You breathe harder than usual

You feel like you’re working a little

It should be easy enough to talk to someone while you’re moving, and

It’s FUN!

When starting to be active, it’s best to choose something you like to do and won’t cost too much money. Walking is a good activity to start with, and it is something you can do where you live, or at a gym or a school track. You can walk anywhere you feel safe and like the scenery! There are also activities you can do in your home, such as walking up stairs, different kinds of leg strengthening activities, and physical activity that will make your heart beat a little faster and make you sweat a little.

What kind of activity can I

do?

Meeting 5

What does it mean to be physically

active?

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Physical activity can be anything you like to do! Just keep moving for at least 10 minutes 3 times per week! Choose any activity you like to do. The most important thing is that you like it and you will keep doing it. Here are a few activities to get your heart beating:

Dancing Aerobics Paddling

Gardening Swimming Housework

Washing a car Walking up stairs

Can you think of any more?

Ideas for physical activity!

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In meeting 1, we learned that when a person has diabetes, their body has trouble using food for energy and they end up with too much sugar in their blood. When you are physically active, your body uses up the sugar in your blood for energy! So when you are active your blood sugar goes down. Once you get started being active and are being physically active regularly, it can help you use up calories even when you are sitting still! Pretty neat! So being physically active can lower your blood sugar and help you keep your weight the same or lose weight. Can you think of some other benefits of physical activity? Because physical activity lowers your blood sugar, you may need less medication. Keep track of your blood sugar and ask your health care provider about any changes in medications. Being physically active makes everything about diabetes a little easier!

How does physical activity lower my blood

sugar?

Ask your provider!

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Here’s how to get started if you are not active already. 1) If you haven’t already done so, check with your doctor to make sure it is okay for you to be physically active. 2 ) Choose something you like to do and begin slowly. If you choose something you like, you will be more likely to keep doing it. 3) If you have not been active for years, do not start with a 3-mile walk! For the beginner, activity can be very light. Try doing more standing activities, light yard work, ironing, cooking, or playing a musical instrument. 4) The next level is light activities such as slow walking. Try walking 10 minutes at a time everyday to get started. Add 10 more minutes each week until you are walking 30 to 45 minutes each time. Remember to sweat a little and get your heart beating a little faster. Other activities could be garage work, house cleaning, and taking care of children. 5) The next level is moderate activity such as walking a mile in 15 minutes, weeding and hoeing a garden for 30-40 minutes, bicycling for 30-40 minutes, and dancing for 30 minutes. 6) Some examples of vigorous activity include speed walking, running, cycling, digging, or swimming fast.

How can I start being active?

Make it FUN!

Begin slowly

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Set small, realistic goals for yourself – and plan to succeed! For example, set the goal of walking two times this week. Even if you walk two times for 5 minutes each time, you will have met your goal. Next week, you might try to walk two times for 10 minutes each time. You may want to keep a record of your progress in a calendar or logbook. You can also add physical activity into your day. Physical activity that is part of your normal routine can also add up to big health benefits! For example, take the stairs instead of the elevator, park the car in the farthest parking space and walk to and from buildings, or stand up and move around when talking to someone on the telephone. Look for ways to make any of your daily errands more active. Can you think of other ways to add physical activity into your day? Congratulations! If you are already active 30 minutes a day, most days of the week, then keep it up! Increasing your physical activity to 45 or 60 minutes most days of the week will really improve your fitness and how you feel. So feel free to pick up the pace and be active a little longer.

Set goals and plan to

succeed!

Make physical activity part of

your day!

What if I’m already active?

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1. Remember when you are active you lose moisture by sweating. You need to replace your body’s fluids by drinking 6 to 8 glasses of water a day.

You should drink more if the weather is hot and humid, especially if you are outdoors. Try to drink a little every 15 to 30 minutes in hot, humid weather. Plain water is the best drink to keep your body operating smoothly.

2. Eating a carbohydrate-rich food within two hours of

physical activity will help you perform better. Half a bagel, crackers, a handful of pretzels, a piece of fruit or a cup of low fat yogurt is enough. Give your body about 30 minutes to digest the food before you are active.

3. Warm up for about five minutes at the beginning of each activity with a slower, gentler version of the activity you plan to do.

4. After the physical activity, cool down by walking or do slow stretches for 5 to 10 minutes.

Activity Tips

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5. Wear light, loose-fitting clothes so that you can sweat freely – they help you cool down.

6. Choose shoes that are right for your activity.

For example, wearing running shoes for aerobics may cause an injury.

7. During exercise, watch for symptoms of low blood sugar. If you are planning a long workout, check your blood sugar every 30 minutes during exercise, especially if you’re trying a new activity or increasing the intensity or duration of your workout.

If you feel any of the following signs then stop your activity right away and see your doctor before you start again:

• Pain or pressure in your chest, stomach, neck, jaw or arms

• Unusual shortness of breath

• Dizziness, nausea or vomiting

• Unusual pulse, shaky, nervous, confused

• Extreme tiredness

Meeting 5 Move More,

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Listen to your body!

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One key to staying active is to make it FUN! Let’s find out what makes an activity fun for you! 1. List some ways to be physically active that you’ve liked in the past: 2. In the lists below and on the next page, check all the things that would make physical activity easy for you: I like being active:

� In the morning.

� During the day

� In the evening

� At any time of the day

� Indoors

� Outdoors

� With music

� Alone

� In teams

� In groups of friends

� With one or two friends

� With my family

Getting started with

your physical activity!

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I like to: I like ways to be active that:

� Compete against myself � Are really fast

� Compete against someone else � Aren’t too fast

� Compete against a team � Are hard

� Not compete at all � Are easy

� Attract an audience

Other:

3. List some activities you would like to try. Then look at the things you checked in the lists above. Next to the activity you would like to try, write the reasons that make it easy in the box next to it.

Activity I would like to try:

Reasons that make it easy

Example: Swimming

Indoors, anytime of day, alone, easy

(Adapted from Building Your Activity Pyramid, Institute for Research and Education HealthSystem Minnesota, 1996.)

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Rewards are a good way to keep us going. Physical activity has a lot of rewards, like lowering blood sugar (glucose), blood pressure, stress, and it can make you stronger. It can be helpful to reward ourselves when we reach a goal. What kind of reward would you give yourself for reaching your exercise goal? When choosing a reward for yourself, try not to think only of food as a reward. Here are some ideas for rewards:

Reading

Go dancing

Call a friend

Go to a movie

Play some music

Work on a hobby

Try a new hairstyle

Go window shopping

Go to the library or bookstore

Watch your favorite TV show

Get a new plant or fresh flowers

Spend time with your child or grandchild

Put 10 cents in a piggybank for each 10 minutes you exercise!

Reward Yourself!

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We learn from each other. Your family and friends learn from watching what you do. You can help your family and friends to be active by getting started with an activity yourself! Here are some reasons to include family and friends in physical activity:

♦ Families and friends who are active regularly may prevent or delay diabetes, heart problems, some kinds of cancer, and feel better!

♦ Family and friends can make physical activity

more fun!

Some people feel selfish if they take time out of their day to be physically active, but staying healthy by being active will also help your family in many ways. If you feel good, you help your family to feel good too. You can take care of each other a lot better when everyone is feeling good and spending quality time together.

Physical activity is good for my family and friends!

If you do it for yourself, you’re doing for your

family too!

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“I hear what you are saying and I’d like to be more physically active, but sometimes things get in the way.”

You’re not alone! We all have excuses:

• No time • Too hot • It’s too hard • I’m just too tired • It’s not safe to go walking • I don’t like physical activity • My spouse won’t let me go walking

These are just a few excuses. Do any of these sound familiar? What keeps you from being physically active? Let’s talk about one of the most common excuses, “I don’t have enough time.” What is at least one thing you could do to make time for you to be physically active? Here are some things you can do if you have the “not enough time” problem.

1. Take several short (10 minute) walks during lunch and breaks from your work.

2. Turn off the TV for 30 minutes and be active. 3. Take the stairs instead of the elevator or escalator. 4. Get a friend or family member to be active with

you. 5. Do sit-ups, stretches, or walk around during

commercials on television.

Excuses, Excuses!

“I don’t have enough time”

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How about, “I’m too tired.” What is at least one thing you could say to yourself to get you moving?

Here are some things you can do if you have the “I’m too tired” problem.

1. Remind yourself that exercise will give you more energy.

2. Plan a short 10 minute walk. Once you get started, it will probably be easy to keep going.

3. Turn on some upbeat music you like to get you going.

4. Get a friend or family member to be active with you.

We all have things that come up which get in the way and may cause us to stop our physical activity once, twice, or even more. Don’t feel guilty or give up! Just get started again as soon as possible and work your way back to achieving your goal. Stay focused on your routine by thinking about all the reasons you decided to stay active in the first place. It may help to have a friend or family member who will support your efforts by encouraging you, and being active with you. Your motivation is as strong as you want it to be!

“I’m too tired”

Don’t give up!

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Let’s do a short role play activity. Mary and Kona have been married for 20 years. They used to be physically active when their children were growing up, but for the past few years they have been too busy with work and have felt too tired after dinner to do anything but watch TV. Kona was diagnosed with diabetes 5 years ago and he has been gaining weight. His blood sugar is high and he’s been feeling tired and depressed lately. His doctor has told him that physical activity may help. In this role play, Kona is going to ask his wife to help him start a walking routine. Kona: Hi Mary, I’m home from work! Hey Mary, it’s a beautiful day outside. Why don’t we go for a short walk? Mary: Well, I was going to get dinner ready now, but maybe later. Kona: Dinner can wait a while. I’m not that hungry right now anyway. Come on, it’s great outside! Mary: Well, all right.

Kona and Mary go for a walk!

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Role Play

As they are walking down their street: Kona: It’s great weather today. I’d really like to start walking after work, and I’d like your company. I think it would really help both of us, and we’d be doing something together. Mary: Well, I’d rather walk in the morning because it’s cooler. Kona: How about if we walk in the morning on Tuesday and Thursday, and after work on Monday, Wednesday, and Friday. Mary: Okay, we can try that for a while.

Has anyone had a similar experience when you asked for support from a friend or family member? What happened?

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There are a lot of excuses we can use to avoid physical activity. But there are just as many ways to get around those excuses! Tips to stay active:

♦ Remember that daily physical activity is the foundation of healthy living for everyone!

♦ Stay focused on your goal.

♦ Reward yourself when you have reached a goal.

♦ Make new goals.

♦ If you stop your physical activity, get started again as soon as possible.

♦ Friends and family may be able to help you reach your goals.

♦ Remember the reasons why you are physically active – for your physical and mental health and your family’s health!

♦ The goal is progress, not perfection!

No Excuses!

Don’t give up!

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Let’s review what we talked about today. Healthy physical activity means that:

You do it at least 10 minutes a day all at one time You do it at least 3-4 times per week Your heart beats faster and you sweat a little It should be easy enough to talk to someone while

your being active, and It’s FUN!

Physical activity lowers blood sugar, helps prevent

or delay diabetes, diabetes complications, heart problems, some cancers, and helps us to be stronger. It can also help our mood and lower stress!

There are lots of ways to be physically active!

Gardening, walking, playing with children, housework, pushing a stroller, aerobics, and dancing.

Plan to start being active 10 minutes each time if

you haven’t been active in a long time. It is best if you can work up to 30 minutes; then 60 minutes for most days of the week.

Reward yourself with non-food rewards.

Let’s Review

Physical activity

lowers blood sugar!

Reward Yourself!

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Now it’s time to set your goal! Take a minute and think of an activity that you would be interested in trying. Think about some of the things you wrote on pages 12 and 13. If you are already doing something, think about ways that you could add more minutes or days to the activity. What activity will you do? How many times per week? /week How long will you do this activity each time? Number of minutes = What will you reward yourself with when you reach your goal?

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Your Goal!

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Meeting 5

We appreciate that you have taken the time to be with us. Before you leave, please take a few minutes to give us your thoughts about today’s meeting.

1. As you were going through today’s meeting, what information did you find especially helpful to you?

2. What goal did you set for yourself? 3. Are there any other comments about today’s meeting that you would like

to share with us?

Thank you!

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There is extra information in the pocket at the end of this meeting to help you be physically active and get to your goal of glucose balance. Thank you for coming and see you next time when we will talk about diabetes and a healthy heart! Don’t forget to bring your notebook.

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Thank you!